The concentration of clotrimazole in the cornea considering the lapse of time after topical administration of 1% clotrimazole, in a single drop or 13 drops at an interval of 5 minutes, was evaluated by agar diffusion bioassay, The rabbits were divided into 3 groups: normal cornea, deepithelized cornea and Aspergillus keratitis, In the case of a single dose, the drug concentration in the normal cornea was lower than the value which can be measured, and the concentration in deeptithelized cornea was significantly higher than in keratitis(p<0.05). In the case of multiple doses, the drug concentration in keratitis was higher than in the deepitheHzed cornea and both of these were higher than in the norma cornea. EspeciaUy the group of keratitis had a significantly higher level(p<0.05) and an abrupt decrease of the drug concentration than the group of deepithelized cornea. This result means that the cornea during inflammation has increased permeability and great metabolic activity. In general the drug concentration in all groups except a single dose in the normal cornea was higher than minimal inhibitory concentration of clotrimazole against A. fumigatus, and this result suggests that the topical administration of 196 dotrimazole is likely to be efficacious in the treatment of Aspergillus keratitis.
Administration, Topical* ; Agar ; Aspergillus ; Biological Assay ; Clotrimazole* ; Cornea* ; Diffusion ; Inflammation ; Keratitis ; Permeability ; Rabbits*

We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
Brain Edema ; Cerebral Infarction* ; Decompressive Craniectomy* ; Female ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Persistent Vegetative State ; Prognosis ; Pupil

Ninety-three patients who had evidence of intraventricular hemorrhage(IVH) were reviewed. Primary and secondary IVH could be well distinguished by computerized tomographic(CT) brain scan. 11 patients had primary pure IVH and remaining 82 patients were secondary IVH from mainly hypertensive intracerebral hemorrhage. Four patients died and 7 survived in the pure IVH. Three of the 4 who died were aneurysmal rupture. Remaining one was unknown etiology. In CT scan hemorrhage was most frequently found in the occipital horns according to the supine position of the patient during the examination and least found in the temporal horns probably due to narrow crescentic shape. In the secondary IVH the distribution of the blood within the lateral ventricle was mainly ipslateral to the intracerebral hematoma. The point of penetration of the intracerebral hematoma into the lateral ventricle was the posterior body in the basal ganglia or thalamic hemorrhage, the frontal horn in the aneurysmal rupture and the trigone in the arteriovenous malformation. Although the level of consciousness on admission related to the size and location of primary intracerebral hemorrhage or IVH, the ventricular dilatation itself also seemed to contribute to the consciousness state. The degree of temporal horn dilatation correlated more with the clinical grade than the frontal horn dilatation.
Aneurysm ; Animals ; Arteriovenous Malformations ; Basal Ganglia ; Brain ; Cerebral Hemorrhage ; Consciousness ; Dilatation ; Hematoma ; Hemorrhage* ; Horns ; Humans ; Intracranial Hemorrhage, Hypertensive ; Lateral Ventricles ; Rupture ; Supine Position ; Tomography, X-Ray Computed

For the reduction of morbidity, such as an acute hydrocephalus, following intraventricular hemorrhage, we attempted to produce a lysis of the experimental intraventricular hemorrhage by a direct intraventricular injection of fibrinolytic agent. Urokinase was used as the fibrinolytic activator. Sixty-four adult rabbits were used in this study. The animals were divided into 5 groups to investigate the effect of urokinase in different time interval of urokinase injection. Intraventricular hemorrhage was made by an injection of 0.3cc of autogenous venous blood. Group I was the control group in which intraventricular injection of blood or urokinase was only done. In Group II and III urokinase was injected into the ventricule 30 minutes and 2 hours after the blood injection. In Group IV urokinase was injected into the ventricle at the same time of the blood injection. In Group V urokinase was injected into the ventricle at the same time of the blood injection, and then the urokinase injection was repeated 24 hours later. The animals of each group were sacrificed on the 1st, 2nd, 3rd and 7th day successively after the experimental procedures. The brains were examined to observe the outcome of intraventricular hematoma with urokinase injection and the consequent changes of the ventricular system grossly and microscopically. The results were as follows : The duration of the remaining hematoma in the ventricles and basal cisterns was 7 days in both the control and the urokinase injection groups equally. In the group of repeated urokinase injection the duration of remaining hematoma in the ventricular system was shortened to 5 days after the blood injection. Upon the ventricular dilatation, the blood injection control group showed moderate dilatation persistently for 1 week ; from minimal to moderate dilatations were found in the urokinase injection groups. In the microscopic examination there were no definite abnormal changes on the ventricular walls and leptomeninges throughout 1 week in the urokinase injection control group. The group of repeated urokinase injection revealed mild flattening and denudation of the ependyma of the ventricular system than the group of single urokinase injection.
Adult ; Animals ; Brain ; Dilatation ; Ependyma ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Injections, Intraventricular ; Rabbits ; Urokinase-Type Plasminogen Activator*

Autogenous costal cartilage graft has been commonly used for reconstruction of auricular deformity. However, the risk of complication and discomfort at the donor site, as well as distortion of the graft due to morphological change in the cartilage have been serious drawbacks to this procedure. Previous studies examining the chondrogenic potential of perichondrium have suggested that perichondrium may be used as graft for cartilage reconstruction. When a perichondrial flap or a free perichondrium was used as graft, new cartilage formed appositional to the grafted perichondrium. However, the neocartilage was often irregular in shape and varied considerably in quantity. In this study, the feasibility of controlling the shape and the mass of neocartilage was investigated using coral, a porous biomaterial, as a template. A coral a template was wrapped with perichondrial flap from the ears of New Zealand white rabbits and placed into a subcutaneous pocket in the rabbits and placed into a subcutaneous pocket in the rabbit's back by incision. A total of 12 animals were used. Formation of new cartilage was later evaluated by gross and histological examination of the perichondrial flap and the coral template. New cartilage was formed in 11 animals. Immature chondrocytes were visible by 3 weeks after the surgery, and by 8 weeks the immature chondrocytes had formed a cartilage. New cartilage was formed only on the surface of the coral template. These results indicated that the shape and the mass of new cartilage may be controlled by using coral template. Therefore, the desired shape of cartilage may be achieved using a coral template of corresponding shape, and this may help in correcting subtle auricular contour defect and in correcting other structural defects that also require new cartilage formation.
Animals ; Anthozoa* ; Cartilage ; Chondrocytes ; Congenital Abnormalities ; Ear ; Humans ; Rabbits ; Tissue Donors ; Transplants

Hemostatic effect is achieved most efficiently by bipolar electrocoagulation in the neurosurgical operation. As far as function is concerned, the laser surgical unit closely resembles the electrosurgical unit. It has been possible to unite arterial vessel ends in a very fast procedure by means of heat application with the laser or bipolar electrocautery. The authors studied the difference between the CO2 Laser and Bipolar Electrocautery Effects on coagulation and anastomosis of vessels experimentally. 46 rats weighing 200gm to 250gm, were used in this study. We divided the experimental animals into 4 groups : 1) arterial coagulation with the CO2 laser, 2) vessel coagulation with the bipolar electrocautery, 3) arterial anastomosis with the CO2 laser, 4) arterial anastomosis with the bipolar electrocautery. The CO2 laser was operated at 10 watts(W) to 50W for vessel coagulation, and 2W for arterial anastomosis. The output of bipolar generation(Malis type) varied from 10 to 80 dial setting (DS) for vessel coagulation or arterial anastomosis. The results obtained were as follows : 1) The lower limit of proper arterial coagulation by the CO2 laser was 20W, 3 seconds(sec) of exposure time with defocused beam. 2) The arteries were properly coagulated with the bipolar coagulator under the DS 30~40, coagulation time 2~4 sec. Over DS 50, the artery perforated to active bleeding. 3) The veins were coagulated satisfactorily under DS 20~30 with 1~5sec. of coagulation time. 4) Both temporary cease of blood flow and using blunt bipolar forceps reduced the coagulation time, and the arteries were not performed over DS 50. 5) Arterial anastomosis was accomplished with 2W, 0.05sec of exposure with 0.2mm of focused CO2 laser beam. With the bipolar coagulator, the arteries could be anastomosed under DS 5~10, 2~3sec. of coagulation time. 6) The patency rate after arterial anastomosis was 71% with the CO2 laser and was 22% with the bipolar coagulator. 7) In the histological examination of coagulated arteries, the entire layers of laser irradiated side revealed destruction and constriction of adventitia and media sparing intima on all around the vessel wall. Anastomosed site revealed coaptation of adventitia and media.
Adventitia ; Animals ; Arteries ; Constriction ; Electrocoagulation* ; Hemorrhage ; Hot Temperature ; Lasers, Gas* ; Rats ; Surgical Instruments ; Veins

This paper reports 3 cases with 46,XX sex reversed male. Three 46,XX hypogonadal subjects showed complete sex reversal and had normal phallus and azoospermia. We studied them under clinical, cytogenetic and molecular aspects to find out the origin of the sex reversal. Patients had markedly elevated serum follicle-stimulating hormone (FSH) and lutenizing hormone (LH) and decreased or normal range of serum testosterone. The testicular volumes were small (3-8ml). Testicular biopsy showed Leydig cell hyperplasia and atrophy of seminiferous tubules. We obtained the results of normal 46,XX and XY dual fluorescent in situ hybridization (FISH) which could rule out the presence of Y chromosome mosaicism. By using polymerase chain reaction (PCR), we amplified short arm (SRY, PABY, ZFY and DYS14), centromere (DYZ3), and heterochromatin (DYZ1) region of the Y chromosome. PCR amplification of DNA from these patients showed the presence of the sex-determining region of the Y chromosome (SRY) but didn't show the centromere and heterochromatin region sequence. The SRY gene was detected in all the three patients. Amplification patterns of the other regions were different in these patients; one had four amplified loci (PABY+, SRY+, ZFY+, DYS14+), another had two loci (SRY+, ZFY+) and the other had two loci (PABY+, SRY+). We have found that each patient's translocation elements had different breakpoints at upstream and downstream of the SRY gene region. We conclude that the testicular development in 46,XX male patients were due to insertion or translocation of SRY gene into X chromosome or autosomes.
Arm ; Atrophy ; Azoospermia ; Biopsy ; Centromere ; Cytogenetics* ; DNA ; Follicle Stimulating Hormone ; Genes, sry ; Heterochromatin ; Humans ; Hyperplasia ; In Situ Hybridization, Fluorescence ; Male* ; Mosaicism ; Polymerase Chain Reaction ; Reference Values ; Seminiferous Tubules ; Testosterone ; X Chromosome ; Y Chromosome

A case of puerperal cerebral hemorrhagic infarction with venous thrombosis in a 36-year-old female is reported. Brain CT scan showed an isodensity area surrounded by ill-defind low density medially in the right frontal lobe, and the most anterior portion of superior sagittal sinus and its draining veins were prominent, but draining veins in the frontal high convexity were not filled in the venous phase of the right carotid angiogram. Osteoplastic craniotomy on the right frontal area was performed to remove the lesion which was mistakenly understood as a mass. Abnormal brain parenchyma was excised from the right frontal subcortical region. Microscopic and pathological evaluation confirmed the diagnosis of hemorrhagic infarction due to venous thrombosis.
Adult ; Brain ; Craniotomy ; Diagnosis ; Female ; Frontal Lobe ; Humans ; Infarction* ; Superior Sagittal Sinus ; Thrombosis* ; Tomography, X-Ray Computed ; Veins ; Venous Thrombosis

No abstract available.
Hepatitis, Chronic* ; Interferon-alpha* ; Killer Cells, Natural* ; Prednisolone*

No abstract available.
Pierre Robin Syndrome*